It's not that the system is broken, per se; it's just that it's expressly designed to allow the private enterprises to maximize their profits, which entails minimizing the operating costs, coverage, and quality of the service – which still isn't affordable enough for the poorest citizens. Anything less than a full demolition is not enough to "fix" the system. You cannot "tame" the industry and make it less exploitative/predatory by letting it loose in your bureaucratic maze – that would be like giving the Minotaur a brand new labyrinth to romp around in.
But you can lobby this complaint against any capitalist economy. The communists did exactly that. The fallacy was they assumed that all profit seeking behavior was destructive. It's not. Profit seeking behavior can have incentives that align with consumers. Just go to any mall to see that.
The difference between malls and private hospitals is that people don't need hamburgers, 3D movies, Vuitton bags, etc. to survive. Profit-seeking behaviour is not necessarily destructive in itself, but applying it to vital services like health care is to maximize its destructive potential.
The problems with the healthcare industry was that the incentives of profit seeking didn't align with the patients. They still dont align. But just pointing that out misses the fact that the incentive problems are a lot, lot less bad. The way an insurance company maximizes it's profit is to now treat people more efficiently rather then drop them.
I don't know enough about the U.S. system to tell if this kind of market optimism is really justifiable,
but in the case of Sweden's health care reforms, these beneficial incentives have simply not materialized.From the abstract:
The main evidence-based effects of these markets and profit-driven reforms can be summarized as follows: efficiency is typically reduced but rarely increased; profit and tax evasion are a drain on resources for health care; geographical and social inequities are widened while the number of tax-financed providers increases; patients with major multi-health problems are often given lower priority than patients with minor health problems; opportunities to control the quality of care are reduced; tax-financed private for-profit providers facilitate increased private financing; and market forces and commercial interests undermine the power of democratic institutions.
Incidentally, this type of fuckery is already evident in Finland as well, as the Swedish companies are trying to gain a foothold around here. First the biggest companies outcompete everyone with predatory pricing, and then they raise the prices to extortionate levels that will bankrupt the poorest municipalities and "force" the companies to shut down their unprofitable services in rural areas. The companies pay practically no taxes on their profits, and competent doctors are lured out of the dwindling public sector with promises of bigger pay by creative tax planning. And only a tiny fraction of the profits is ever reinvested into the companies to improve the abysmal quality of their services – the rest is laundered via the Channel Islands as tax-free "capital gains."
In short, the companies have
zero incentive to
not give the state and her taxpayers a deep dicking – the fruits are just too low-hanging and juicy to ignore. And this is not a bug, but an
essential feature of the system: the right-wing visionaries behind these policies see nothing wrong with a little bit of dickery and tax evasion because taxes should not exist in the first place, and the clueless center-right liberals are blissfully duped by great promises of Magical Markets That Solve All Problems.
Although it's pretty tragic that American liberals want to solve the endemic diseases of the system with more of the same, the most ironic thing is that Uncle Bern keeps touting the Swedish model as The Way of the Future, while the actual system is rapidly becoming A Thing of the Past. Nothing can magically "fix" the system overnight, or in five years or five decades – it has to be torn down and smashed to pieces, like all of capitalism.
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Topic: Murrican Politics Megathread 2016: There Will Be Hell Toupée (Read 1580787 times)